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MANAGEMENT OF PATIENTS WITH MULTI-DRUG RESISTANT/EXTENSIVELY DRUG-RESISTANT TUBERCULOSIS IN EUROPE: A TBNET CONSENSUS STATEMENT
Lange, Christoph et al. | Date Issued: 2014
Author
Lange, Christoph
Abubakar, Ibrahim
Alffenaar, Jan-Willem C
Bothamley, Graham
Caminero, Jose A
Carvalho, Anna Cristina Calçada
Chang, Kwok-Chiu
Codecasa, Luigi
Correia, Ana
Crudu, Valeriu
Davies, Peter
Dedicoat, Martin
Drobniewski, Francis
Duarte, Raquel
Ehlers, Cordula
Erkens, Connie
Goletti, Delia
Günther, Gunar
Ibraim, Elmira
Kampmann, Beate
Kuksa, Liga
Lange, Wiel de
van Leth, Frank
van Lunzen, Jan
Matteelli, Alberto
Menzies, Dick
Monedero, Ignacio
Richter, Elvira
Rüsch-Gerdes, Sabine
Sandgren, Andreas
Scardigli, Anna
Skrahina, Alena
Tortoli, Enrico
Volchenkov, Grigory
Wagner, Dirk
van der Werf, Marieke J
Williams, Bhanu
Yew, Wing-Wai
Zellweger, Jean-Pierre
Cirillo, Daniela Maria
Affilliation
German Center for Infection Diseases. Research Center Borstel. Medical Clinic. Division of Clinical Infectious Diseases. Borstel, Germany / University of Namibia, School of Medicine. Windhock, Namibia.
University College of London. MRC Clinical Trials Unit. Research Dept of Infections and Population health. London, UK.
University of Groningen. University Medical Center Groningen. Dept. of Clinical Pharmacy and Pharmacology. Groningen, The Netherlands.
Homerton University Hospital. London, UK.
University Hospital of Gran Canaria " Dr. Negrin" . Dept. of Pneumology. Las Palmas de Gran Canaria, Spain / International Union against Tuberculosis and Lung Disease (The Union). Tuberculosis and HIV Dept., Multi-Drug-Resistant Tuberculosis Unit. Paris, France.
University of Brescia. WHO Collaborating Centre for TB/HIV Co-infections. Clinic of Infectious and Tropical Disease, Brescia, Italy / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em terapias, Ensino e Bioprodutos (LITEB). Rio de Janeiro, RJ, Brasil.
Tuberculosis and Chest Service. Dept. of Health. Hong Kon, China.
Niguarda Ca`Granda Hospital. Villa Marelli Institute. Regional TB Reference Centre. Milan,Italy.
Portuguese Northern Health Administration. Public Health Dept. Porto, Portugal.
Phthisiopneumology Institute. Chisanu, Republic of Moldova.
Liverpool Heart and Chest Hospital. Liverpool, UK.
Heart of Enland Foundation Trust. BIrmingham, UK / University of Warwick. Coventry, UK.
Public Health England National Mycobacterial Reference Laboratory. Imperial College. London, UK.
Centro Hospitalar de Vila Nova de Gaia / Espinho. Portuguese Reference Centre for M/XDR-TB / University of Porto. Institute of Public Health. Predictive Medicine and Public Health. Dept. of Clinical Epidemiology. Porto, Portugal.
Take That TB. Hamburg, Germany.
KNCV Tuberculosis Foundation. The Hague, The Netherlands.
" L`Spallanzani" National Institute for Infectious Diseases (INMI). Dept. of Epidemiology and Preclinical Research. Translational Research Unit. Rome, Italy.
German Center for Infection Diseases. Research Center Borstel. Medical Clinic. Division of Clinical Infectious Diseases. Borstel, Germany / University of Namibia, School of Medicine. Windhock, Namibia.
Marius Nasta Institute of Pulmonology. Bucharest, Romania.
Imperial College. Dept. of Pediatrics. London, UK / MRC Unit. Vaccinology Theme. The Gambia.
Riga East University Hospital. Tuberculosis and Lung Disease center. Riga, Latvia.
University Medical Center Groningen. Tuberculosis Center Beatrixoord. Groningen, The Netherlands.
University of Amsterdam. Academic Medical Center. Dept. of Global Health. Amsterdam, The Netherlands / Amsterdam Institute of Global Health and Development. Amsterdam, The Netherlands.
University Medical Center Hamburg. Infectious Diseases Unit. Hamburg, Germany.
University of Brescia. WHO Collaborating Centre for TB/HIV Co-Infection. Clinic of Infectious and Tropical Diseases. Brescia, Italy.
McGill University. Montreal Chest Institute. Montreal, Canada.
The Union. Tuberculosis and HIV Dept. Multidrug-Resistant Tuberculosis Unit. Paris, France / Hospital Serveis Clinic. Barcelona, Spain.
Research Center Borstel. National Reference Center for Mycobacteria. Borstel, Germany.
Research Center Borstel. National Reference Center for Mycobacteria. Borstel, Germany.
European Centre for Disease Prevention and Control (ECDC). Stockholm, Sweden.
The Union. Tuberculosis and HIV Dept. Multidrug-Resistant Tuberculosis Unit. Paris, France.
Republican Research and Practical Centre for Pulmonology and Tuberculosis. Minsk, Belarus.
San Raffaele Scientific Institute. Emerging Bacterial Pathogens Unit. Milan, Italy.
Center of Excekkence for TB Infection Control. Vladimir Regional TB Dispensary. Vladimir. Russia.
University Medical Center Freiburg. Center for Infectious Diseases. Center for Chronic Immunodeficiency, Freiburg, Germany.
ECDC. Stockhol, Sweden.
North West London Hospitals NHS Trust. Dept. of Paediatrics. London, UK.
The Chinise University of Hong Kong. Stanley Ho Centre for Emerging Infectious Diseases. Hong Kong, China.
Swiss Ling Association. Berne, Switzerland.
San Raffaele Scientific Institute. Emerging Bacterial Pathogens Unit. Milan, Italy
Abstract
The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) substantially challenges TB control, especially in the European Region of the World Health Organization, where the highest prevalence of MDR/XDR cases is reported. The current management of patients with MDR/XDR-TB is extremely complex for medical, social and public health systems. The treatment with currently available anti-TB therapies to achieve relapse-free cure is long and undermined by a high frequency of adverse drug events, suboptimal treatment adherence, high costs and low treatment success rates. Availability of optimal management for patients with MDR/XDR-TB is limited even in the European Region. In the absence of a preventive vaccine, more effective diagnostic tools and novel therapeutic interventions the control of MDR/XDR-TB will be extremely difficult. Despite recent scientific advances in MDR/XDR-TB care, decisions for the management of patients with MDR/XDR-TB and their contacts often rely on expert opinions, rather than on clinical evidence. This document summarises the current knowledge on the prevention, diagnosis and treatment of adults and children with MDR/XDR-TB and their contacts, and provides expert consensus recommendations on questions where scientific evidence is still lacking.
Keywords in Portuguese
Tuberculose
Resistência a Medicamentos
Europa
 
Keywords
Tuberculosis
Drug-resistant
Europe
Multidrug-resistant
 
Publisher
The ERS
Citation
LANGE, Christoph et al. Management of patients with multidrugresistant/ extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement. Eur Respir J , v.44, n.1, p.23–63, 2014.
DOI
10.1183/09031936.00188313
ISSN
1399-3003